Anti Fungal and Malaria Flashcards
What do azoles target?
ergosterol
What does Amphotericin B target?
Bind to ergosterol and creates leaky pores
Amphotericin B: ADEs
- Nephrotoxic
2. Infusion reactions (chills, fever, muscle spasms, hypotension)
Flucytosine: ADEs
- Renal excretions
2. Myelosuppression (suppression of stem blood cells)
Which Azole is eliminated in the urine unchanged?
Fluconazole
Which Azole is best for aspergillosis?
Voriconazole
Which Azoles are best for Blastomycosis?
- Itraconazole
2. Fluconazole
Which Azole is best for Mucormycosis?
posaconazole
Why isn’t ketoconazole used in systemic fungal infections?
inhibits hepatic and adrenal P450s
Azoles: ADEs
- tough on the liver
- GI upset
- Rash
Voriconazole: ADEs
- visual disturbances
- Class D in pregnancy
Which antifungal is best taken orally for mucocutaneous fungal infections because it can accumulate in keratin?
Terbinafine
What is first line therapy for aspergillus infection?
Voriconazole
What is first line therapy for everything but aspergillus?
Amphotericin B
What are the 3 most important ADEs of antifungals?
- Heptatic transaminases
- Rash, photosensitivity
- GI upset
Name 3 diseases caused by protozoa?
- Malaria
- Giardia
- Trichomoniasis
What is the treatment(s) of choice for Malaria?
Doxycycline*
Chloroquine
Mefloquine
Which anti-malaria drugs are for treatment and chemoprophylaxis?
- Chloroquine*
- Mefloquine
- Primaquine* (also treats other plasmodiums)
- Atovaquone-proguanil
- Doxycycline
What is the drug of choice for malaria prevention in travelers?
Chloroquine**
if resistance–> Malarone, Mefloquine
What is the drug of choice in malaria prevention in travelers if multi-drug resistance?
Doxycycline
What should you advise your patient to avoid if they are taking Metronidozole?
alcohol as it will cause violent stomach upset and vomiting
Which malaria drug should be avoided in neurological disorders?
Chloroquine
Which malaria drug should be avoided in mental health problems?
Mefloquine
Which malaria drug should be avoided in pregnant women/breast feeding women?
Proguanil with atovaquone
Doxycycline (also don’t give this to kids under 8)
Treatment for leishmaniasis?
Sodium stibogluconate
Pneumocystis jirovecii treatment?
TMP-SMX
Treatment for tichomonas vaginalis?
Metronidazole
